SINGLE-DOSE AZITHROMYCIN FOR THE TREATMENT OF CHANCROID - A RANDOMIZED COMPARISON WITH ERYTHROMYCIN

Background and Objectives: Chancroid is endemic in sub-Saharan Africa and enhances the sexual transmission of the human immunodeficiency vir us Type 1 (HIV-1). Azithromycin is an orally absorbed macrolide antibi otic that is active against Haemophilus ducreyi, the causative agent o f chancroid, and has pharmacokinetic properties that are suitable for single dosing. Study Design: In a randomized single-blinded study of 1 27 men presenting to a referral STD clinic with culture proven chancro id, we compared the efficacy of azithromycin, administered as a single 1 g dose, with erythromycin 500 mg given 4 times daily for 7 days. Re sults: Cure rates were 89% (73 of 82) in the azithromycin group and 91 % (41 of 45) in the erythromycin group. A failure to respond to treatm ent was associated with HIV-1 seropositivity and a lack of circumcisio n. Both regimens were well tolerated. Conclusions: Azithromycin, given as a single 1 g oral dose, is an effective treatment for chancroid in men, and offers major prescribing advantages over erythromycin.